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Introduction: During periods of isolation, people with substance use disorders may reduce tension, stress, uncertainty and possible distress by increasing the use of substances or practices that they have abused. The objective of this study was to evaluate the impact of the pandemic on emergency care and continuity of care for patients with substance use disorders.

Method: Study carried out in the only psychiatric emergency service in the province at the Hospital Universitario Santa María de Lérida, which cares for 431,183 people. Sociodemographic, clinical and evolutionary variables were collected from all the patients treated during a period prior to lockdown (January 13, 2020, until March 14, 2020) and during the first (March 15, 2020 until June 20, 2020) and second states of emergency (from October 25, 2020 to May 9, 2021).

Results: 908 patients attended with substance use disorder, representing 23.8% of all visits. During the first state of emergency, visits increased (p < 0,001) with a decrease in the average age (p = 0.0023). During the second state of emergency, there was an increase in the use of alcohol with respect to the rest of toxic substances (p < 0,001) and an increase in the visits of patients without prior follow-up (p = 0.005).

Conclusions: Substance use disorder consultations increased in the first state of emergency, with patients being younger and attending for reasons related to outpatient discontinuity, while in the second state of emergency, alcohol use increased in people without prior follow-up and with small social networks. Admissions in the first state of emergency were shorter, with no subsequent link to other detoxification treatment centers and with an earlier return to the emergency room, especially in female users.

Problematic use of the Internet among adolescents has risen in the last decade. The Compulsive Internet Use Scale (CIUS) is one of the most frequently internationally-used tools developed to assess Problematic Internet Use (PIU). However, evidence concerning its validity and reliability in its Spanish version for the adolescent population is currently lacking. Thus, the main goal of the present study was to analyse the psychometric properties of CIUS scores in a large sample of Spanish adolescents. The sample consisted of 1,790 participants (53.7% female, mean age = 15.70 years old, SD = 1.26). The one-dimensional model displayed appropriate goodness of fit indices after error covariance of five items were allowed to correlate. Strong measurement invariance was found for the one-dimensional model across age and gender. The McDonald's Omega coefficient for the total score was 0.91. Furthermore, PIU was positively associated with different indicators of poor wellbeing and psychological difficulties and negatively associated with prosocial behaviour, self-esteem and sense of belonging to the educational centre. The study provided evidence of validity for the CIUS, confirming its utility for screening PIU in non-clinical adolescents.

In its action plan (2022-2030) to reduce the harmful use of alcohol, WHO calls on economic operators to "substitute, whenever possible, higher-alcohol products with no-alcohol and lower-alcohol products in their overall product portfolios, with the goal of decreasing the overall levels of alcohol consumption in populations and consumer groups". This paper investigates substitution within beer brands at the level of the consumer, based on Spanish household purchase data using interrupted time series analysis. For households (n = 1791, 9.1% of all households) that newly bought at least one of eleven branded zero-alcohol beers (responsible for over three-quarters of all zero-alcohol beer purchased), the associated purchases of all grams of alcohol after the first purchase of zero-alcohol beer were reduced by 5.5%, largely due to substituting every one litre of higher strength beer (ABV > 3.5%) with 0.75 litres of same-branded zero-alcohol beer (ABV = 0.0%). For households (n = 337, 1.8% of all households) that had never previously purchased a same-branded higher-strength beer, but newly purchasing a same-branded zero-alcohol beer, the associated purchases of all grams of alcohol after the first purchase of zero-alcohol beer were reduced by 14%; this reduction was largely due to such households' decreasing their associated purchases of wines and spirits. Thus, at the level of the consumer, based on Spanish household purchase data of branded zero-alcohol beers, the evidence behind WHO's call for substitution appears to be substantiated.

Given the causal impact of alcohol use on stroke, alcohol control policies should presumably reduce stroke mortality rates. This study aimed to test the impact of three major Lithuanian alcohol control policies implemented in 2008, 2017 and 2018 on sex- and stroke subtype-specific mortality rates, among individuals 15+ years-old. Joinpoint regression analyses were performed for each sex- and stroke subtype-specific group to identify timepoints corresponding with significant changes in mortality rate trends. To estimate the impact of each policy, interrupted time series analyses using a generalized additive mixed model were performed on monthly sex- and stroke subtype-specific age-standardized mortality rates from January 2001-December 2018. Significant average annual percent decreases were found for all sex- and stroke subtype-specific mortality rate trends. The alcohol control policies were most impactful on ischemic stroke mortality rates among women. The 2008 policy was followed by a positive level change of 4,498 ischemic stroke deaths per 100,000 women and a negative monthly slope change of -0.048 ischemic stroke deaths per 100,000 women. Both the 2017 and 2018 policy enactment timepoints coincided with a significant negative level change for ischemic stroke mortality rates among women, at -0.901 deaths and -1.431 deaths per 100,000 population, respectively. Hemorrhagic stroke mortality among men was not affected by any of the policies, and hemorrhagic stroke mortality among women and ischemic stroke mortality among men were only associated with the 2008 policy. Our study findings suggest that the impact of alcohol control policies on stroke mortality may vary by sex and subtype.

One of the factors that increase the likelihood of adolescents starting to exhibit and consolidate anti-social behavior is drug use, with a consistent pattern of consumption of different substance found in young offenders (Aebi, Bessler & Steinhausen, 2021). A cognitive-behavioral group treatment program inspired by the positive psychology approach was developed and applied to drug use in minors deprived of liberty (experimental group); the results were compared to those of a group of adolescents with the same type of drug use in the same center (active control group) at two points in time: during and after incarceration. The fall in the rate of problems associated with drug use after incarceration in the experimental group was statistically significant compared to the control group, and the effect size of the experimental condition was large (ῆ2 = 0.55), much higher than the control group (ῆ2 = 0.16). The treatment program has proven to be an effective tool for reducing problems associated with drug use and is especially effective in reducing alcohol and cannabis consumption.

The objective was to analyze the changes in cannabis use during lockdown considering sex, age, living situation and level of addiction. This descriptive and non-probabilistic study used a convenience sample of 208 participants with ages between 18-57 years (64.3% men; mean age = 31.39 years), that reported consuming cannabis. The frequency of distinct typologies of cannabis use was analyzed and the level of addiction with the Cannabis Abuse Screening Test (CAST). An online survey was used to collect the variables under study. A total of 25% consumers increased their spliff (marijuana mixed with tobacco) consumption, 11.9% increased their joint (marijuana cigarette) consumption and 11.8% increased their hashish spliff consumption. Men had higher levels of cannabis addiction, however, during lockdown they reduced their marijuana spliff consumption while both men and women increased their joint consumption. Marijuana spliff consumption showed a greater increase in the 25-29 age group, in those living with people other than relatives or a partner, alone, or with a partner and was reduced mainly in those living with parents or other relatives. The living alone 18-24 years old group, and the living with parents 35-44 years old group showed higher levels of cannabis addiction (CAST). The rate of dependent consumers who increased their marijuana spliff consumption (49%) doubled compared to consumers with no addiction and moderate addiction. Regarding joints, consumption was 1.5 times higher than for moderate addiction consumers and three times higher than those with no addiction. The risk of cannabis addiction increased in certain groups during lockdown.

The profits obtained by the gambling industry in Spain represent almost one point of GDP and the proportion of minors who have gambled has reached a quarter. This situation occurs despite the law regulating gambling, which included among its objectives the prevention of addictive behaviors, as well as the protection of minors and other vulnerable groups. Recently, an additional regulation was approved to control gambling advertising. Bearing in mind the new regulatory context, we analyze the relationship between advertising and gambling in adolescents and young adults, studying especially young people who have already gambled and minors. We conducted an empirical investigation with a sample of 2,181 adolescents and young adults who filled out a questionnaire on gambling and advertising. We found that the variables associated with advertising are significantly related to gambling behavior and that, in addition, this correlation occurs with greater magnitude in men. We obtained higher scores in advertising influence among those subjects who have ever gambled compared to those who have not, highlighting the importance of discouraging the arrival of new gamblers. Regarding minors, we found significant differences in the different variables of advertising influence compared to young adults. These findings point to the need to evaluate this influence considering the new habits and interests of minors today.

In recent years, studies have highlighted the upward trend in electronic cigarette use among adolescents, as well as the potential of e-cigarette use to lead to subsequent conventional cigarette use. The study's aims were two-fold: 1) to examine the progression from e-cigarette use to conventional cigarette use; and 2) to analyze the differences in the severity of smoking pattern among dual users (i.e., e-cigarette and conventional cigarette use), cigarette-only smokers, and e-cigarette-only users in a Spanish adolescent population. Data were obtained from the ESTUDES, a representative survey of addictive behaviors of Spanish adolescents aged 14-18, which was comprised of 38,010 adolescents (Mage = 15.69; SD = 1.19; 51.35% females). Results indicate that lifetime e-cigarette use increased the prevalence of subsequent conventional cigarette use by 1.86 times (95% CI 1.74, 1.99), and the prevalence of conventional cigarette use in the last month by 2.38 times (95% CI 2.19, 2.58), independently of whether the e-cigarette contains nicotine or not. Dual users showed a higher percentage of daily smokers, and a greater number of cigarettes per day, a higher use of e-cigarettes with nicotine, and an earlier age of smoking onset. Regarding risk perception, e-cigarette-only users perceived both conventional tobacco and e-cigarettes as less harmful (all p-values < .001). These findings document the strength of association between e-cigarette and conventional cigarettes, and underscore the importance of developing legal restrictions and prevention strategies aimed at reducing e-cigarette use, which in turn would reduce tobacco use.

Microelimination strategies for the hepatitis C virus (HCV) in vulnerable populations, such as users of Addiction Centres (AC), are key for the elimination of hepatitis C. The aim of the HepCelentes project was to design a certification program for AC from the generation of a guide with the criteria to favour the prevention, diagnosis, control, and treatment of HCV in Spain. The project was structured in 4 phases: normalisation, implementation, certification, and communication. In the first phase, developed between July and December 2020, a Steering Committee was created (formed by representatives of scientific societies, healthcare professionals from AC, primary care centres and hospital units, and patient associations) that, from of an exhaustive bibliographic review, generated by consensus an accreditation guide for AC. The guide consists of 22 criteria (15 mandatory and 7 recommended) structured based on the requirements to be met by AC, justification for the selection, level of action (management, prevention, diagnosis and treatment/follow-up), measurement of the indicator, objective level to be achieved, evidence of compliance, clarifications to improve understanding, and mandatory / recommendation (depending on their relevance to achieve HCV elimination and its feasibility for implementation in real practice). The development of a certification system for the AC, based on consensus and coordination of multidisciplinary teams, is intended to favour the management of hepatitis C and its elimination in AC users, supporting the international, national, and regional elimination strategies.